Active NPI
Lynda Mueller, MD
- Family Medicine Physician
- Manor, TX
National Provider Identifier
1104915412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- Q5700
- Practice address
- 600 W Carrie Manor St
Manor, TX 78653-5035 - Phone
- (512) 978-9780
- Fax
- (512) 901-9739
- NPI assigned
- Oct 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 19565 | OK | |
| Family Medicine Physician | 207Q00000X | Q5700 | TX | Primary |
Addresses
Primary practice location
600 W Carrie Manor St
Manor, TX 78653-5035
Mailing address
600 W Carrie Manor St
Manor, TX 78653-5035
Phone (512) 978-9780
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100201150A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160222001199 | TX | Order and Referring Only - Family Practice | 3971683160 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453334400000",
"number": "1104915412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 W CARRIE MANOR ST",
"city": "MANOR",
"state": "TX",
"postal_code": "786535035",
"telephone_number": "512-978-9780",
"fax_number": "512-901-9739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 W CARRIE MANOR ST",
"city": "MANOR",
"state": "TX",
"postal_code": "786535035",
"telephone_number": "512-978-9780",
"fax_number": "512-901-9739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUELLER",
"first_name": "LYNDA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2016-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "19565",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "Q5700",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100201150A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Manor, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.